Hamid Hassan Flashcards
The salivary glands are exocrine merocrine glands, define exocrine and merocrine
Exocrine: secrete products through ducts opening onto epithelium
Merocrine: no part of cell lost during secretion by using vesicles and exocytosis
What type of fibres stimulate salivary secretion
Parasympathetic reflexes
Sympathetic stimulation
What is the acini
Secretory unit producing saliva
What is the pathway of the salivary gland and cell types throughout
Acinar cells cluster around lumen
Lumen empties into intercalated duct lined with simple cuboidal epithelium
Empties into striated duct of simple columnar
Empties into excretory duct of stratified cuboidal
Empties into collecting duct of stratified cuboidal
What is the difference in staining of serous and mucous acinar
Serious have basophilic secretory vesicles around lumen and are acidic so stain purple with HandE
Mucous stain paler with h and e
What are myoepithelial cells
Epithelial cells with muscular features that lie between basal lamina and basal membrane of acinar cells and intercalated duct
What do myoepithelial cells do
4
Reduce back flow of saliva
Accelerate outflow
Reduce luminar volume
Increase secretory pressure
What is a key feature of striated duct structure
2
Basal surface has foldings with mitochondria for energy to aid active transport
Luminar surface has microvilli to increase SA
What occurs in striated duct to make saliva hypotonic
Reabsorbtion of Na and Cl
Secretion of k and HCO3
How is the parotid gland divided
What is it’s duct called
Where does it’s duct empty
Deep part and superficial part divided by facial nerve
Stensons
Upper 2nd molar
What is blood supply to parotid gland
External carotid artery
What is the venous drainage of the parotid gland
External jugular vein
What structure is superior to parotid gland
TMJ
What structure is posterior to parotid gland
Mastoid process
What structure is anterior to parotid gland
Angle of mandible
Medial pterygoid plate
Massater
Stylomandibular ligament
What saliva is produced by submandibular gland
What is it’s duct and where does it drain
Mixed
Wartons
Lingual frenulum
How is the submandibular gland divided
Superficial part below mylohyoid and deep part above mylohyoid
What is the blood supply to submandibular gland
2
Submental artery
Sublingual artery
What is the venous drainage of submandibular gland
Submental vein into facial vein into internal jugular vein
What saliva is secreted by sublingual gland
What is it’s duct called and where does it empty
Mucous saliva
Bartholins
Several openings in floor of mouth
What is the blood supply of sublingual gland
2
Submental artery
Sublingual artery
What is the venous drainage of sublingual gland
Submental vein into facial vein into internal jugular vein
What is the most common type of minor salivary glands
Why is saliva from minor salivary duct high in sodium
Mucous
No intercalated or striated duct
Where are glands of Von ebner
What type of saliva do they produce
Circumvallate papillae
Serous
Where are mucous minor salivary glands found
3
Hard palate
Soft palate
Lingual tonsils
Where are serous minor salivary glands found
Lingual sulcus terminalis in circumvalate papillae
Where are mixed minor salivary glands found
Tip of tongue
What nerve innervates the parotid gland and what is it’s pathway to the parotid gland
Parasympathetic innervation from lesser petrosal nerve of glossopharyngeal
Inferior Salavitory nucleus in medulla
Through jugular foramen
Through tympanic canuliculus into middle ear
Out of middle ear and through hiatus of lesser petrosal nerve into middle cranial fossa
Through foramen ovale
Otic ganglion to parotid gland
What nerve innervates submandibular and sublingual glands
What is it’s pathway
Parasympathetic innervation via chorda tympani of facial nerve
Superior salavotory nucleus in pons
Through internal acoustic meatus as facial nerve to middle ear
Chorda tympani given off
Lingual nerve of V3 joins chorda tympani
Submandibular ganglion to SM and SL glands
What provides sympathetic innervation to the salivary glands
What is it’s pathway
T1-T4 Thoracic vertebrae 1-4 Super cervicular ganglion Internal carotid plexus Deep petrosal nerve SM SL and Parotid glands
How much saliva is produced a day
What % saliva is water
1-1.5 l
99%
What is whole saliva composed of
6
Saliva Epithelial cells Neutrophils Lymphocytes Bacteria GCF
What are the roles of saliva
11
Buffering Pellicle formation Remineralisation Salivary proteins Clensing Immunity Lubrication Digestion Taste Water balance Wound healing
What is the component in saliva responsible for buffering
What’s its concentration in stimulated and unstimulated saliva
Bicarbonate
Unstimulated 1mmol per litre
Stimulated 60mmol per litre
What reaction allows bicarbonate to buffer
HCO3- ➕ H+ ➡️ H2CO3 ➡️ H2O ➕ CO2
How thick is the pellicle
What does it do
2
1-10 micrometers
Diffusion barrier
Base of adhesion
How does saliva aid remineralisation
Increases concentration of ions available to remineralise hydroxyapatite
What are the salivary proteins in saliva
4
Statherin
Proline rich proteins
Cystatins
Histatins
What does statherin do
Prevents precipitation of calcium phosphate to maintain high calcium availability for remineralisation
What do proline rich proteins do
2
Maintain concentration of calcium in saliva by binding to it and adsorbing to hydroxyapatite surface
Inhibit hydroxyapatite growth
What do cystatins do
Inhibit proteases of periodontal disease
What do histatins do
Antimicrobial proteins that assist homeostasis and help pellicle formation
How does saliva repair early caries
Inhibitors in saliva prevent crystal growth in enamel on surface of lesion to keep pores open for remineralisation
How does saliva cleanse the oral cavity
Washes away noxious agents, bacteria and food debres to the gut
What is the role of IgA
Limits microbial adherence and agglutinate bacteria
Where is IgG derived from
GCF
What does lysozyme do
Breaks down bacteria walls
What does lactoferrin do
Binds to ions and inhibits Bacteria growth with lysozyme
What do mucins do
What glands are they derived from
Aggregate bacteria
sublingual, submandibular and minor salivary glands
What do histatins do
Helps form pellicle and inhibits candida albicans
What do defensins do
Aggregate bacteria and integrate into lipid bilayer to disrupt
How does saliva aid digestion
Amylase from parotid gland helps break down starch by hydrolising alpha 1,4 linkages into maltose and dextrin
How does saliva aid body water balance
When we are dehydrated saliva rate decreases causing dry mouth which stimulates tactile receptors which send impulses to hypothalamus to create conscious awareness of thirst
What is normal unstimulated flow
0.3-0.4 ml/min
What is normal stimulated flow
1-3ml / min
What is unstimulated flow in xerostoma
Below 0.1 ml /min
What is stimulated flow rate in xerostomia
Below 0.7ml / min
What drug is used for xerostoma
Pilocarpine
What are the main organs of GI tract
5
Oral cavity Oesophagus Stomach Small intestine Large intestine
What are the accessory organs of the GI tract
6
Teeth Tongue Salivary glands Liver Gall bladder Pancrease
What is the pH of the oral cavity
5-7
What type of epithelium line esophagus
Non keratinised stratified squamous
What are the laters of wall lining GI tract
4
Adventia / serosa
Muscularis externa
Submucosa
Mucosa
What is the difference between serosa layer or adventia layer
Serosa is slippery and serous, adventia is thick and fibrous
Where is serosa found
6
Stomach Spleen Liver Duodenum Transverse colon Sigmoid colon
Where is adventia found
5
Duodenum Cecum Ascending colon Descending colon Pancrease
What are the layers of muscularis externica and what do they do
3
Outer longitudinal- relaxes and lengthens to pull food forward
Myenteric plexus- causes smooth muscle relaxation when activated
Inner circular- contract and constrict behind food
What are the layers in mucosa in GI tract
3
Epithelial layer
Lamina propria
Muscularis mucosa
What is the role of liver in relation to GI tract
Makes bile
What are the muscle layers in muscularis externica of the stomach
3
Longitudinal
Circular
Oblique